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Comparison of early results of posterior capsule opacification in eyes with Steroid induced cataracts-A Case Control st

Comparison of early results of posterior capsule opacification in eyes with Steroid induced cataracts-A Case Control study. Dr.Gauri Shah, MS Dr. Vaishali A. Vasavada , MS Dr.Mamidipudi R Praveen, DOMS Dr. Abhay R. Vasavada , MS, FRCS (England) Dr.Samaresh Srivastava, DNB .

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Comparison of early results of posterior capsule opacification in eyes with Steroid induced cataracts-A Case Control st

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  1. Comparison of early results of posterior capsule opacification in eyes with Steroid induced cataracts-A Case Control study Dr.Gauri Shah, MS Dr. Vaishali A. Vasavada , MS Dr.Mamidipudi R Praveen, DOMS Dr. Abhay R. Vasavada , MS, FRCS (England) Dr.Samaresh Srivastava, DNB Iladevi Cataract & IOL Research Centre, Ahmedabad,India The authors have no financial interest

  2. Aim Materials and Methods To compare postoperative PCO development between cataractous eyes that had a history of steroid usage and those that did not • Study design : Prospective case-control study . • Study Population: • Cases : n=30patients with posterior subcapsular cataract with a history of steroid • intake in oral, inhaled, injectable, or topical forms for ≥4 months. • Controls :n=60 Age – matched healthy individuals with a posterior- subcapsular • cataract. • Phacoemulsification with single-piece hydrophobic acrylic (SN60AT)IOL • implantation in cases and controls. • Digital retro-illumination images were captured at 1 month and 1 year post- • operative. Posterior Capsule Opacification(PCO) was evaluated using the EPCO • 2000 software. • Exclusion Criteria :Glaucoma , high myopia (axial length > 27.0 mm), ocular • disorders , previous ocular surgeries , and pupil dilatation less than 7 mm .

  3. Distribution of disease

  4. Distribution of administration of various modalities of steroids

  5. Primary Observations • The amount of PCO was measured using the EPCO 2000 software and reported in terms of EPCO score and EPCO area • PCO measurements were done within the capsulorhexis margin and also the central 3 mm of the optic area. Secondary Observations • Log MAR Visual Acuity • Nd:YAG capsulotomy rates . Results

  6. Results : Comparison of PCO within the Capsulorhexis margin

  7. Results : Comparison of PCO within Central 3 mm area at 1 Year

  8. Secondary Observations Mean Log MAR visual acuity at the 1 year follow-up Nd: YAG laser capsulotomies at 8.2 months follow –up :

  9. Case Baseline 1 Year Control 1 Year Baseline

  10. Total Cover Baseline 1 Year Partial Cover Baseline 1 Year

  11. Mansfield KJ, Cerra A Effects of dexamethasone on posterior capsule opacification-like changes in a rat lens explant model Mol 2004; 10:728-37 Conclusion:Lens cell behavior in this PCO model was significantly affected by inclusion of DEX, highlighting the possibility that its use as an anti-inflammatory at the time of cataract surgery may influence PCO development Zaczek A , Zetterstrom C Posterior capsule opacification after phacoemulsification in patients with postoperative steroidal and nonsteroidal treatment J Cataract Refract Surg. 2004; 30:316-20 Conclusion : Topical installation of diclofenac , dexamethasone or placebo in the immediate period after phacoemulsification and IOL implantation did not seem to influence the formation of PCO 2 years after cataract surgery • Neumayer T, Beuhl W, Findl O • Effect of topical prednisolone and diclofenac on the short-term change in • morphology of posterior capsular opacification. • Am J Ophthalmol. 2006 Oct;142(4):550-6 • Conclusion: Topical prednisolone and diclofenac do not influence the short-term • change of Elschnig pearls. Elschnig pearls disappear and appear within days. The • degree of progression and regression varies greatly among eyes

  12. Conclusion Steroid induced PSC was associated with a higher incidence of PCO after cataract surgery at the one year follow-up

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